The health care crisis of childhood-onset bipolar illness: some recommendations for its amelioration.

摘要: Objective To describe new data on the incidence and impact of childhood- adolescent-onset bipolar illness make recommendations to help accelerate acquisition knowledge in this area. Data sources Two large, multicenter out-patient studies adults with DSM-IV disorder-the Systematic Treatment Enhancement Program for Bipolar Disorder Collaborative Network-were primary retrospective age at onset. Study selection We focused 2 because they supplied more immediate onset long-term prognosis than current prospective studies. synthesis The revealed that 15% 28% experienced an their prior 13 years. Those childhood versus adult had a severe, complicated, adverse course illness, assessed retrospectively confirmed prospectively during naturalistic treatment. time lag from first symptoms treatment was strongly inversely related averaged 16.8 +/- 10 years those Recommendations include defining temporary consensus threshold criteria each subtype prodromes; conducting using less onerous traditional designs, including randomized open comparisons acquire preliminary cohort; forming clinical academic outcome networks quickly understudied population. Conclusions reveal very substantial rate childhood-onset extraordinary delays treatment, outcome. Several approaches accelerating cohort are outlined.